Loading...
804 N MAGNOLIA AVE (3)Permit Types BLD ELE MEC PLM t Permit Number:BLD2009-Q2086 Issued:07/13/2009 INSPECTION REQUEST LINE: (714)765 -4626 Quarter Section:25 Site Address:804 N MAGNOLIA AVE Legal Description:NTR 2118 LOT 149 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)7«-5153 Project Description:Electrical to upgrade service to 200 amp panel.Work started prior to permit. Valuation; Construcion Types: Total Fees paid for Permit: N/A, 273.46 People Associated with Project: Owner PILAR C PANGANIBAN Permit Applicant PRISCILO PANGANIBAN 804 N MAGNOLIA AVE ANAHEIM CA 92801-3109 Electrical Fixtures Qty Type Plumbing FixturesType Qty Type Mechanical Fixtures Qty Meter/Disc Sw -under 600 V,up to 200 amps 1 The permit shall expire by limitationand becomenull and void if the building or work has not passed final inspection 365 days from the date of permit issuance.A new permit is required to commence or continue work.fblcl permit combo All applicable items below must be signed betore utilitios will 0?7gleased. FINAL INSPECTIONS DATE INSPECTORCityofAnaheim Building Division Final Gas Test Electrical Final Plumbing Final Mechanical Final Cross Connection Control (7i4)76s-428o Engineering/Grading Final i7i4>765-5i26 Fire Dept.Final (714)765-5041 Fire Sprinkler Final (714)765-5041 Water Engineering (714)765-4591 Do not occupy this building until the linal inspections have been made. BUILDING PERMIT DOES NOT AUTHORIZE ELECTRICAL.PLUMBING.OR MECHANICAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED. Sub List/Business License (714)765-5194 Zoning (714)765-5139 Building Final (Last Inspection - Only After Above Complete) INSPECTION DATE INSPECTOR Do not pour concrete until the following applicable items have been signed: Plumbing (Ground/Underfloor Drain Waste)FINAL INSPECTION must be approved by the Building Division. Electrical Ground Electrode/Ufer PARTIAL INSPECTIONS Setback/Forms/Trenches (Footings) Do not install subfloor or pour floor slab until the foilwing applicable items have been signed:Building Inspections Plumbing (Ground/Underfioor Water) Underfloor Rough Gas Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) Floor (Joist/Girders) Underfloor Insulation (Raised Foundation Only) 2nd Floor (Floor Nailing) Mechanical InspectionsDonotcoverorconcealtheworkbelowuntilthefollowingapplicableitemshave been signed: 1st Floor Shear Firesprinkler (Rough)(Fire Dept.) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Plumbing InspectionsRoughMechanical Rough Electrical Framing (Only after PIbg.,Ele.,Mec.&Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Drywall Penetrations (Ele.,Mec.&PIbg.) Interior Lath Exterior Lath Electrical InspectionsGENERALITEMS Electrical Service Meter Exterior Plaster (Brown Coat) T-Bar (Struct.,Ele.,or Mec.) Sewer Water Engineering Backflow (Testable Only) Water Service Permit Backs Master-2008.xls Permit Types BLD ELE MEC PLM .X Permit Number:BLD2009-02086 Issued:07/13/2009 INSPECTION REQUEST LINE: (714)765 ●4626 Quarter Section;25 CITY OF ANAHEIM BUILDING DIVISION 200 S,ANAHEIM BLVD. (714)765 -5153 Site Address:804 N MAGNOLIA AVE Legal Description:N TR 2118 LOT 149 OWNER -BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Lawforthe following reason(s)indicated below by the checkmarl^s)I have placed next tothe applicable item(s)(Sec.7031.5 Business and Professions Code:any city or county which requires a permit to construct,alter,improve,demolish or repair any structure,priorto its issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant tothe provisions of the Contractors'State License Law Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for apem^J^ubjects the applicant to a civil penaltv of not more than five hundred dollars ($500). -I,as owner of property,or my employees with wages as their sole compensation,will do {_)portions of the work,and the structure is not intended or offered for sale (Sec.7044 Business and Professions Code:The Contractors'State License Law does not apply to anownerofpropertywho,through employees'or personal efforts,builds or improves the property,provided that the improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale). I,as the owner of the property,am exclusively contracting with licensed Contractors to construct the project (Sec.7044 Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who builds or improves thereon,and who contracts for the projects with a licensed Contractor pursuant to the Contractor's State License Law). I am exempt from licensure under the Contractors'State License Law for the following reason: By my signature below 1 ackonowledge that,except for my personal residence in which I must have resided for at least one year prior to completion oftheimprovementscoveredbythispermit,I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entiretybylicensedcontractors,I understand that a copy of the applicable law.Section 7044 of the Business and Professions Code,is available upon requestwhenthisapplicationissubmittedoratthefollowingWebsite:http://www.Ieainfo.ca.aov/calaw.htmI. By my signature below,I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information !have provided is correct. I agree to comply with all applicable city and county ordinances and stale laws relating to building construction I authofiz entatives of pity or county to enter the above-identified property for inspection purposes. 7-/3-D<? 'Signat^e of Owner or Authorized Agent Date / WORKER'S COMPENSATION DECLARATION: WARNING;FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for worker's compensation,issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain worker's compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued.My worker's Compensation insurance carrier and policy are: Policy No.;Expiration Date:lamer: Name of Agent:Phone No.: I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the worker's compensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply with those provisions. 7-13-09 Si|\xeJb\Applicant Date Permit Number:BLD2009-02086 DECLARATION REGARDING CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agencyfor the performance of the work for which this permit is issued(Sec.3097.Civ.C): Lender's Name: Lender's Address: LICENSED COt^RACTORS DECLARATION: i hereby affirm under the penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my iicense is in full force and effect. Contractor Signature Date NUMBER EXPiRATiON DATE LiCENSE TYPE (S) The permit shall expire by limitation and become null and void if the building or work has not passed final inspection 365 days from the date of permit issuance.A new permit is required to commence orconthue work. fbid permit combo declare City of Anaheim PLANNING DEPARTMENT BUILDING DIVISION Owner-Builder Acknowledgment and Information Verification Form *Per California State Law,if you,the property owner,will be coming to our office to get a permit,we will provide you with this form when you arrive.If you are sending your agent,please complete,initial,and sign the information below.Also make sure that you have provided your agent with a signed Authorization to Act on Behalf of the Property Owner Form with the required forms of identification. Dear Property Owner: An application for a building permit ha property improvements specified at , 5 been submitted in your parcie listing yourself as the builder of theI-f W. We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. / We will not issue a building permit until you have read,initialed your understanding of each provision, signed,and returned this form to us at our official address indicated.An agent of the owner cannot execute this notice unless you,the property owner,obtain the prior approval of the permitting authority. Owner's Acknowledgment And Verification of Information p^ECTIONS:Read and initial each statement below to signify you understand or verify this information. L I.I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder”building permit that erroneously implies that the property owner is providing his or her own laborand material personally.I,as an Owner-Builder,may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property.My homeowner’s insurance may not provide coverage for those injuries.I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. _2.1 understand building permits are not required to be signed by property owners unless they are 'responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3.I understand as an "Owner-Builder”I am the responsible party of record on the permit.I understand fhat!may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 'n 4.I understand Contractors are required by law to be licensed and bonded in California and to listtheirlicensenumbersonpermitsandcontracts. w 5.I understand if!employ or otherwise engage any persons,other than California licensed Contractors,and the total value of my construction is at least five hundred dollars ($500),including labor and materials,I may be considered an "employer”under state and federal law. ^^6.I understand if I am considered an "employer"under state and federal law,I must register with thestateandfederalgovernment,withhold payroll taxes,provide workers'compensation disability insurance, and contribute to unemployment compensation for each "employee."I also understand my failure to abide by these laws may subject me to serious financial risk. uyll i If MARCH 2009 200 S.Anaheim Blvd..Suite 145 Anaheim,California 92805 1714)765-5153 Phone (714)765-4607 Fax www anaheim,net/buil ding B72I 7.I understand under California Contractors'State License Law,an Owner-Builder who builds single-Tamily residential structures cannot legally build them with the intent to offer them for sale,unless all work is performed by licensed subcontractors and the number of structures does not exceed four within anycalendaryear,or ail of the work is performed under contract with a licensed general building Contractor. 8.I understand as an Owner-Builder if I sell the property for which this permit is issued,I may be heldfiableforanyfinancialorpersonalinjuriessustainedbyanysubsequentowner(s)that result from anylatentconstructiondefectsintheworkmanshipormaterials. _9.I understand i may obtain more information regarding my obligations as an "employer"from theinternalRevenueService,the United States Small Business Administration,the California Department of Benefit Payments,and the California Division of Industrial Accidents.I also understand I may contact the California Contractors'State License Board (CSLB)at I-800-321 -CSLB (2752)or www.cslb.ca.gov for more information about licensed contractors. 10.lam aware of and consent to an Owner-Builder building permit applied for in my name,and i^e f^jjmposed construction activity at theunderstandthatIanithepartyl^allv and firiancial yfollowingaddress:oO^AJ-vr I I.I agree that,as the party legally and financially responsible for this proposed construction activity,*'1 will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. W 12.I agree to notify the issuer of this form immediately of any additions,deletions,or changes to anyoTtheinformation1haveprovidedonthisform.Licensed contractors are regulated by laws designed to protect the public.If you contract with someone who does not have a license,the Contractors'State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint.Your only remedy against unlicensed Contractors may be in civil court.It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property,you may be held liable for damages.If you obtain a permit as Owner-Builder and wish to hire Contractors,you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers’compensation insurance coverage. Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license,form notarization,or other verification acceptable to the agency is required to be pre^pted when the permit is issued to verify the property owner’s signature. Property Owner's Signature:/^Date: PACE 2 OF 2 200 S.Anaheim Bivd.,Suite I45 Anaheim.California 92805 (714)765-5153 Phone (714)765-4607 Fax www.anaheim.net/buil ding B721